The effects of count of platelets PCT PDW and PTZ inr values on prognosis in patients admitting to emergency department with snake bite

Snake bite is an important health problem in World especially in tropic areas. It is seen more frequently especially in the summer months and it is an important cause of mortality and morbidity in the South and southeast in our region. The differentiation of snake species and venom by region may naturally cause the clinical signs and symptoms of the patients to be different. In some areas the treatment of the patient becomes severely difficult because of the snake species cannot be detected. Snake venom has a complex structure consisting of many toxic proteins and enzymes. The poison has cardiotoxic, neurotoxic, myotoxic, nephrotoxic and hemotoxic properties. According to the severity of toxin local or systematic symptoms are observed. In addition to local findings such as pain, heat increase, hemorrhagic edema, ecchymosis, lymphangitis and tissue necrosis such as fever, neusea, vomiting, circulatory collapse, jaundice, delirium, convulsion and coma may ocur. Death can occur in 6-48 hours with secondary infections, disseminated intravasculer coagulation neurotoxicity, acute renal failure, intracranial and pulmonary hemorrhage. In our study, 294 snake bite cases admitted to the emergency department between 01.01.2010 and 01.11.2017 were evaluated retrospectively. The sociodemographic characteristics and laboratory result of 195 patients who are in conformity with the study criteria were recorded. All hemogram parameters and PTZ-INR values of the patients were recorded in the study forms prepared as standard of admission time at 24 hours and 48 hours. All information was taken from the hospital automation system. Patients were divided into 4 groups according to the clinical stating of snake bites. In additon, patients were compared for bite areas, complication development and antivenom treatment. Sociodemographic characteristics and laboratory parameters were evaluated in terms of differences between groups. As a result, Plt, Pct, MPV, PDW, PTZ and INR can be evaluated at the time of snake bite but prognosis determination (the necessity of admission to the intensive care unit, complication or development of rhabdomyolysis etc.) 24th and 48th hour Plt and Pct values were found to be more valuable. Although it is not statistically significant, the development of complications especially rhabdomyolysis and the severity of these complications in the lower extremity compared to the upper extremity are also remarkable result.